Conduct disorder in adolescent females: current state of research and study design of the FemNAT-CD consortium

Abstract

Conduct disorder (CD) is a common and highly impairing psychiatric disorder of childhood and adolescence that frequently leads to poor physical and mental health outcomes in adulthood. The prevalence of CD is substantially higher in males than females, and partly due to this, most research on this condition has used all-male or predominantly male samples. Although the number of females exhibiting CD has increased in recent decades, the majority of studies on neurobiological measures, neurocognitive phenotypes, and treatments for CD have focused on male subjects only, despite strong evidence for sex differences in the aetiology and neurobiology of CD. Here, we selectively review the existing literature on CD and related phenotypes in females, focusing in particular on sex differences in CD symptoms, patterns of psychiatric comorbidity, and callous-unemotional personality traits. We also consider studies investigating the neurobiology of CD in females, with a focus on studies using genetic, structural and functional neuroimaging, psychophysiological, and neuroendocrinological methods. We end the article by providing an overview of the study design of the FemNAT-CD consortium, an interdisciplinary, multi-level and multi-site study that explicitly focuses on CD in females, but which is also investigating sex differences in the causes, developmental course, and neurobiological correlates of CD.

Altered Neuronal Responses During an Affective Stroop Task in Adolescents With Conduct Disorder

“…CD is categorized according to its age of onset (childhood-onset versus adolescent-onset), severity (mild, moderate, or severe), and the presence or absence of callous-unemotional (CU) traits (DSM-5 specifier “with limited prosocial emotions”). Moreover, adolescents with CD can exhibit either predominantly reactive/impulsive or proactive/instrumental aggression, which is associated with the levels of CU traits ( Mathias et al, 2007 ; Freitag et al, 2018 ). While adolescents with reactive aggression mainly show impulsive behavior, those with proactive aggression usually present with increased CU traits.…”

Störung des Sozialverhaltens und Antisoziale Persönlichkeitsstörung - Herausforderungen in der Transition vom Jugend- zum Erwachsenenalter

“…[1]. Verschiedene Risikofaktoren, wie angeborene genetische und Temperamentsfaktoren, elterliches Erziehungsverhalten, aber auch die Wohnumgebung, das Verhalten von Gleichaltrigen sowie zahlreiche schulische und gesellschaftliche Faktoren tragen zur Entwicklung von Störungen des Sozialverhaltens im Kindes-und Jugendalter bei [2,3,4]. Störungen des Sozialverhaltens, sowohl ODD als auch CD, weisen eine hohe psychiatrische Komorbidität auf, die altersspezifisch ist: Im Vorschul-und Grundschulalter liegt meist eine oppositionelle Störung des Sozialverhaltens vor, die häufig zusammen mit einer Aktivitäts-und Aufmerksamkeitsstörung (ADHS), aber auch Angst-und autistischen Störungen sowie Teilleistungsstörungen vorkommt.…”

Focused issue on conduct disorder and aggressive behaviour

“…In this focused issue of ECAP, we present selected works from the consortia showing how we deal with some of the challenges listed above. We present a review on females with CD [ [6]…”

“…While evidence-based international clinical guidelines, which summarize the current state of the art regarding diagnosis and intervention of CD, such as NICE [10], emphasize a strong evidence for interventions in childhood; research on effective treatments of CD and aggressive behaviour in adolescence, and on preventive measures for detrimental adult outcomes is still in its infancy. Our understanding of the underlying neurobiology of CD remains rudimentary, and predictors of longitudinal outcomes associated with CD and aggression have rarely been studied despite their clinical and societal impact [6].…”